1. Field of the Invention
The present invention relates to an apparatus useful for treating and handling both respiratory gases and liquids going both to and from the patient. More particularly, in the invention relates to an apparatus which includes liquid traps, suction valves, and a check valve that are preferably effective to protect one or more components of the apparatus from being clogged internally or contaminated through exposure to contaminants both internal and external to the apparatus.
2. Description of the Related Art
During surgery and other medical procedures, a patient is frequently connected to an anesthesia machine or ventilator to provide respiratory gases to the patient. The respiratory gases passed to the patient are advantageously filtered, heated and humidified so that the gases entering the patient are of a suitable quality, temperature and humidity so as to positively impact the patient. Heat and moisture exchangers (HMEs) are often used to provide heat and humidity to the respiratory gases entering the patient. Typically, these HMEs are located so that respiratory gases exhaled from the patient pass through a tracheal tube into the HME, including at least one fibrous or other gas permeable material, which accumulates or collects heat and moisture from the exhaled gases. A filter element, for example, an antimicrobial filter element, is often located in the HME to filter respiratory gases passing through the HME. During the inhalation of respiratory gases, for example, from a respiratory ventilator machine, the HME provides higher levels of heat and moisture to these respiratory gases prior to the gases entering the patient. Over a period of time, the HME is effective to maintain a certain level of temperature and humidity in the respiratory gases entering the patient.
Although such HMEs do perform effectively to provide at least some of the useful heat and humidity needed for respiratory gases under normal conditions, additional required patient treatments and/or patient expectorations may cause adverse effects to the HMES. One example of such an additional treatment is the use of saline or other aqueous liquids to loosen partially hydrated mucous secretions in the trachea of the patient. Mucous build-up is of particular concern in situations when the patient is an infant or neonate and/or in long term, for example, about six (6) hours or longer, use of a ventilator. Saline lavage is often used to counter such mucous buildup. Thus, saline or other aqueous solution is introduced through an inserted tracheal catheter to loosen mucous secretions in the trachea. If the clinician accidentally gets the aqueous solution sloshing back with an exhaled breath or does not suction it correctly in a timely manner, the liquid can fill up or block a good portion of the flow area of the HME and/or the HME""s filter element, thereby drastically increasing the pressure required to pass respiratory gases back and forth. In this situation, the entire HME may have to be replaced in order to effectively allow respiratory gases to pass to and from the patient. Such HME replacement is an emergency and can be disruptive and/or harmful to the patient and/or can cause additional clinician stress, in addition to opening up the patient""s breathing circuit to external contaminants.
Respiratory gas circuits can include a humidifier and a filter located between the patient and the ventilator. Such circuits are of particular value in treating infants and neonates, for example, with lung volumes on the order of about 10 cubic centimeters. However, liquid water can condense in the tubing from the humidifier and be xe2x80x9cblownxe2x80x9d or carried to the filter, where such liquid can cause increased pressure drop causing non-optimal ventilation and disadvantageously making for more difficult or impossible respiration.
A patient""s health is compromised by the introduction of pathogens on dust and other foreign matter into the HME on the patient side of the bacteria filter. The pathogens and foreign matter can invisibly foul the HME filter or treatment unit rendering it ineffective for its desired purpose. The pathogens and other foreign matter are often introduced by exposing the interior of the respiratory equipment to atmospheric air. The interior of the respiratory circuit is exposed to the atmosphere when suction ports connected to the liquid traps are opened to attach a suction conduit thereto and/or the HME filter is replaced frequently or unplugged from the endotracheal suction manifold to drain the liquid manually. The tracheal tube is also exposed to atmospheric air when a port in the endotracheal suction manifold is opened to introduce saline solution to the trachea during a tracheal lavage. The exposure of the interior of the respiratory apparatus components to pathogens and other foreign matter results the patient""s lungs being exposed to the contaminants during respiration through the unit.
The decrease in the useful life of the HME unit is costly and not beneficial to the patient in several ways. A shorter useful life of the HME unit results in more units needed to treat a patient, more chances for pathogen contamination, more clinician work, more physical and mental stress on the patient, and an increase in cost of the patient""s medical care. The increased exposure to bacteria and other foreign matter results in increased opportunity for respiratory system infections and other detrimental medical situations, as is disclosed in U.S. Pat. No. 4,224,939 to Lang entitled BACTERIA-TIGHT SYSTEM FOR ARTIFICIAL RESPIRATION, which is incorporated herein by reference in its entirety.
It would be advantageous to provide apparatus by which respiratory gases can be effectively and reliably treated and which can be protected against liquid material interfering with such treatment, causing problems with the respiration of the patient, and restricting the exposure of the interior respiratory equipment to the external ambient room atmosphere and its inevitable contamination.
An apparatus for treating the respiratory gases of a patient has been discovered. The apparatus comprises a housing with a patient side port, a machine side port, two or more liquid trap chambers, a treatment chamber, and a wall. The patient side port is adapted for passing respiratory gases between the housing and the patient. The machine side port is adapted for passing respiratory gases between the housing and a respiration machine. The liquid trap chambers are adapted to receive liquid. The treatment chamber contains a treatment component adapted to provide a benefit to the respiratory gases passing therethrough. The patient side and machine side ports, the treatment chamber, and the liquid trap chambers are positioned to define a respiratory flow path through the housing passing between the patient side and machine side ports and through the treatment chamber and the liquid trap chambers. The wall has one or more openings through which liquid is removable from the liquid trap chambers. The openings are spaced apart from the patient and machine side ports.
In an aspect of the invention, the liquid trap chambers are configured to inhibit liquid passed from outside the housing through the patient side port from entering the treatment chamber.
In an aspect of the invention, the liquid trap chambers are sized and positioned to hold liquid passed from outside the housing through the patient side port.
In an aspect of the invention, the treatment component is selected from the group consisting of: (1) a filter element adapted to filter respiratory gases passing through the housing; (2) a gas permeable member adapted to exchange heat and moisture with respiratory gases passing through the housing; (3) a generating material adapted to generate water and/or heat available to humidify respiratory gases passing through the housing; (4) a hygroscopic component adapted to generate heat available to heat respiratory gases passing through the housing; (5) porous thermal mass heat exchanger material with high surface area; and (6) combinations thereof.
In an aspect of the invention, at least one of the liquid trap chambers is sized and positioned to collect liquid between the treatment chamber and the patient side port.
In an aspect of the invention, at least one of the liquid trap chambers is sized and positioned to collect liquid between the treatment chamber and the machine side port.
In an aspect of the invention, a first liquid trap chamber is sized and positioned to collect liquid between the treatment chamber and the patient side port. Further, a second liquid trap chamber is sized and positioned to collect liquid between the treatment chamber and the machine side port. In a further aspect of the invention, a third liquid trap container is sized and positioned to collect liquid between the treatment chamber and the first liquid trap chamber. In a still further aspect of the invention, a baffle is disposed between the first and third liquid trap chambers. The baffle may be of an annular shape.
In an aspect of the invention, the treatment chamber further comprises a gas flow bypass extending through the treatment chamber, wherein the gas flow bypass is linearly aligned with the patient side port. In a still further aspect of the invention, a check valve is in fluid communication with the gas flow bypass. The check valve is adapted to inhibit gas flow from the machine side port, through the gas flow bypass, and to the patient side port. The check valve is further adapted to enable a portion of gas flow and/or liquid from the patient side port to flow through the gas flow bypass and towards the machine side port, with the remainder of the gas flow from the patient side port being directed through the treatment chamber. In a still further aspect of the invention, a baffle is disposed between the patient side port and the treatment chamber, wherein the patient side port, the gas flow bypass, and a hole in the baffle are linearly aligned. In a further aspect of the invention, the check valve is a leaf check valve.
The discovered invention is also embodied in an apparatus for treating the respiratory gases of a patient. The apparatus comprises a housing and a suction assembly. The housing comprises with a patient side port, a machine side port, one or more liquid trap chambers, a treatment chamber, and a wall. The patient side port is adapted for passing respiratory gases between the housing and the patient. The machine side port is adapted for passing respiratory gases between the housing and a respiration machine. The liquid trap chambers are adapted to receive liquid. The treatment chamber contains a treatment component adapted to provide a benefit to the respiratory gases passing therethrough. The patient side and machine side ports, the treatment chamber, and the liquid trap chambers are positioned to define a respiratory flow path through the housing passing between the patient side and machine side ports and through the treatment chamber and the liquid trap chambers. The wall has one or more openings through which liquid is removable from the liquid trap chambers, wherein the openings are spaced apart from the patient and machine side ports. The suction assembly is in fluid communication with the one or more openings. The suction assembly is adapted to remove liquid from the liquid trap chamber without exposing the respiratory flow path through the housing to the ambient atmosphere.
In an aspect of the invention, the suction assembly comprises a suction manifold comprising one or more inlets in fluid communication with the one or more liquid trap chambers, respectively, and an outlet adapted for connection to a suction source. The suction assembly also comprises valves that are disposed between the wall openings and the suction manifold outlet, wherein the valves are adapted to control suction through the wall openings.
In an aspect of the invention, the liquid trap chambers are configured to inhibit liquid passed from outside the housing through the patient side port from entering the treatment chamber.
In an aspect of the invention, the liquid trap chambers are sized and positioned to hold liquid passed from outside the housing through the patient side port.
In an aspect of the invention, the treatment component is selected from the group consisting of: (1) a filter element adapted to filter respiratory gases passing through the housing; (2) a gas permeable member adapted to exchange heat and moisture with respiratory gases passing through the housing; (3) a generating material adapted to generate water and/or heat available to humidify respiratory gases passing through the housing; (4) a hygroscopic component adapted to generate heat available to heat respiratory gases passing through the housing; (5) porous thermal mass heat exchanger material with high surface area; and (6) combinations thereof.
In an aspect of the invention, at least one of the liquid trap chambers is sized and positioned to collect liquid between the treatment chamber and the patient side port.
In an aspect of the invention, at least one of the liquid trap chambers is sized and positioned to collect liquid between the treatment chamber and the machine side port.
In an aspect of the invention, a first liquid trap chamber is sized and positioned to collect liquid between the treatment chamber and the patient side port. Further, a second liquid trap chamber is sized and positioned to collect liquid between the treatment chamber and the machine side port. In a further aspect of the invention, a third liquid trap container is sized and positioned to collect liquid between the treatment chamber and the first liquid trap chamber. In a still further aspect of the invention, a baffle is disposed between the first and third liquid trap chambers. The baffle may be of an annular shape.
In an aspect of the invention, the treatment chamber further comprises a gas flow bypass extending through the treatment chamber, wherein the gas flow bypass is linearly aligned with the patient side port. In a still further aspect of the invention, a check valve is in fluid communication with the gas flow bypass. The check valve is adapted to inhibit gas flow from the machine side port, through the gas flow bypass, and to the patient side port. The check valve is further adapted to enable a portion of gas flow from the patient side port to flow through the gas flow bypass and towards the machine side port, with the remainder of the gas flow from the patient side port being directed through the treatment chamber. In a still further aspect of the invention, a baffle is disposed between the patient side port and the treatment chamber, wherein the patient side port, the gas flow bypass, and a hole in the baffle are linearly aligned. In a further aspect of the invention, the check valve is a leaf check valve.
The discovered invention is also embodied in a system for treating the respiratory gases of a patient. The system comprises a liquid trap and a device comprising a respiratory gas treatment chamber. The liquid trap comprises a trap housing and a trap chamber. The trap housing has a patient side port being adapted for fluid communication with a tracheal tube device, and a machine side port being adapted for fluid communication with a device comprising a respiratory gas treatment chamber. The trap chamber is positioned in the trap housing between the patient side port and the machine side port. The trap chamber is adapted to receive liquid. The liquid trap housing does not contain a filter or other respiratory gas treatment chamber. The device comprising the respiratory gas treatment chamber is similar, if not the same, as other devices describe herein. The machine side port of the trap housing is in fluid communication with a patient side of the device comprising the respiratory gas treatment chamber. The trap housing is spaced apart from the housing of the device comprising the respiratory gas treatment chamber.
In an aspect of the invention, the system further comprises a suction assembly in fluid communication with an opening in a wall of the trap housing through which liquid in the trap is removable via the suction assembly without exposing the respiratory flow path through the trap housing to ambient atmosphere.
In an aspect of the invention, the trap housing comprises a wall having an opening through which liquid is removable from the trap chamber. Further, the system comprises a suction manifold and a valve. The suction manifold has an inlet in fluid communication with the trap chamber and an outlet adapted for connection to a suction source. The valve is disposed between the wall opening and the suction manifold outlet, wherein the valve is adapted to control suction through the wall opening.
In an aspect of the invention, the liquid trap further comprises a baffle disposed in the trap housing. The baffle is adapted to be impinged upon by a respiratory gas flow passing between the patient side port and the machine side port and through the trap housing. In a further aspect of the invention, the baffle comprises a blocking member positioned in a direct path between the patient side port and the machine side port.
In a still further aspect of the invention, the suction assembly is adapted to facilitate periodic removal of liquid from the device liquid trap chambers and the trap chamber of the liquid trap without exposing the device liquid trap chambers and the trap chamber of the liquid trap to the atmosphere outside of the device and the liquid trap.
In a still further aspect of the invention, the suction assembly is adapted to facilitate periodic removal of liquid from the device liquid trap chambers and the trap chamber of the liquid trap without separating the suction manifold from the device wall openings and the liquid trap wall opening.
The discovered invention is also embodied in a respiratory gas treatment system comprising an endotracheal suction manifold comprising a device port, a patient side port, a machine side port, a liquid trap, and a wall. The device port is adapted for connection with a respiratory treatment device. The patient side port is adapted for passing respiratory gases between the endotracheal suction manifold and the patient. The machine side port is adapted passing respiratory gases between the endotracheal suction manifold and a respiration machine. The liquid trap is adapted to receive liquid. The patient side port, the machine side port, and the liquid trap are positioned to define a respiratory flow path through the endotracheal suction manifold passing between the patient side and machine side ports and through the liquid trap. The wall has an opening through which liquid is removable from the liquid trap, wherein the opening is spaced apart from the patient side port and the machine side port.
In an aspect of the invention, a suction catheter assembly is functionally connected to the device port.
In an aspect of the invention, a medication delivery apparatus, a metered dosed inhaler, or a nebulizer is functionally connected to the device port.
In an aspect of the invention, the system further comprises an apparatus for use during tracheal lavages functionally connected to the device port. The apparatus comprises a housing and a microbial filter. The housing has a first port and a second port, the first port being adapted to receive a lavaging liquid, the second port being adapted to be in fluid communication with a tracheal tube in fluid communication with the patient side port. The microbial filter is disposed in the housing. The first and second ports and the microbial filter are positioned so that gas or lavaging liquid passes from the first port to the second port and through the microbial filter.
In an aspect of the invention, the system further comprises a suction manifold and a valve. The suction manifold comprises an endotracheal inlet and an outlet. The endotracheal inlet is in fluid communication with the liquid trap. The outlet is adapted for connection to a suction source. The valve is disposed between the wall opening and the suction manifold outlet, wherein the valve is adapted to control suction through the wall opening.
In a still further aspect of the invention, the system further comprises an apparatus for treating the respiratory gases of a patient. The apparatus comprises a housing comprising a housing patient side port, a housing machine side port, a treatment chamber, a housing liquid trap, and a housing wall. The housing patient side port is functionally connected to the machine side port of the endotracheal suction manifold. The housing patient side port is adapted for passing respiratory gases between the housing and the patient. The housing machine side port is adapted for passing respiratory gases between the housing and the respiration machine. The treatment chamber contains a treatment component adapted to provide a benefit to the respiratory gases passing therethrough. The housing liquid trap is adapted to receive liquid from the respiratory gases passing therethrough. The housing patient side port, the housing machine side port, the housing treatment chamber, and the housing liquid trap are positioned to define a respiratory flow path through the housing passing between the housing patient side and housing machine side ports and through the treatment chamber and the housing liquid trap. The housing wall has an opening through which liquid is removable from the housing liquid trap. The suction manifold further comprises an apparatus inlet in fluid communication with the housing liquid trap through the housing wall opening. The system further comprises an apparatus valve disposed between the housing wall opening and the suction manifold outlet, wherein the apparatus valve is adapted to control suction through the housing wall opening.
The discovered invention is also embodied in a swivel fitting for use in respiratory gas flow connections to treatment devices. The swivel fitting comprises a female part, a male part, and a circumferential bead. The female part comprises an interior surface that defines a passage extending through the female part. The male part comprises an exterior surface and an interior surface, wherein the exterior surface complements at least a portion of the female part interior passage and the interior surface defines a gas flow passage extending therethrough. The circumferential bead extends outward from the male part exterior surface, the bead defining a plane that is normal to an axis extending along the gas flow passage. The bead and the female part exterior surface are adapted such that upon insertion of the male part into the female part passage, the bead forms a bead deformation undercut in the female part interior surface, thereby creating and maintaining a seal between the male part exterior surface and the female part interior surface and a retaining force to inhibit axial movement.
In an aspect of the invention, the female part interior surface and the male part exterior surface have a taper of less than two degrees per side.
In an aspect of the invention, the swivel fitting is installed in a device having an interior gas pressure of approximately two psi gauge.
In an aspect of the invention, the female part passage is in fluid communication with a wall opening a wall of a respiratory gas treatment device housing. Additionally, the male part gas flow passage is in fluid communication with an inlet of a suction manifold.
In an aspect of the invention, the swivel fitting forms a fluid connection between a respiratory gas treatment device and another respiratory gas treatment device.
In an aspect of the invention, the female part is comprised of a material that is softer than the bead. In a further aspect of the invention, the female part comprises a butadiene/styrene mixture and the bead comprises acrylic, acrylic-butadiene/styrene mixture, or polycarbonate.
The discovered invention is also embodied in an apparatus for use during tracheal lavages. The apparatus comprises a housing and a microbial filter. The housing has a first port and a second port, the first port being adapted to receive a lavaging liquid, and the second port being adapted to be in fluid communication with a tracheal tube. The microbial filter disposed in the housing, wherein first and second ports and the microbial filter are positioned so that gas or lavaging liquid passes from the first port to the second port and through the microbial filter.
In an aspect of the invention, the second port is in fluid communication with a suction catheter assembly.
In an aspect of the invention, the second port is in fluid communication with an endotracheal suction manifold.
In an aspect of the invention, the first port comprises a Luer check valve.
In an aspect of the invention, the first port is adapted to receive a nozzle of a squeezable container or a bulk container.
The discovered invention is also embodied in a method for providing respiratory gases to a patient comprising the step of providing a closed container which contains an apparatus as described above. The closed container is then opened. A suction assembly of the apparatus is placed in fluid communication with a suction source. A patient side port of the apparatus is placed in fluid communication with a patient. A machine side port of the apparatus is placed in fluid communication with a respiration machine.
In an aspect of the invention, a step of identifying a liquid-containing liquid trap chamber from the one or more liquid trap chambers adapted to receive liquid is performed. Next, liquid from the liquid-containing liquid trap chamber is suctioned out of the chamber using the suction assembly. The process is repeated as needed without exposing the liquid traps chambers to the atmosphere.
In an aspect of the invention, an auxiliary liquid trap chamber is installed between the patient side port and the patient such that the apparatus and the auxiliary liquid trap chamber is in fluid communication with the patient. The auxiliary liquid trap chamber is spaced apart from the apparatus housing.
In an aspect of the invention, a combined endotracheal suction manifold/fluid trap is installed between the patient side port and the patient such that the apparatus and the endotracheal suction manifold/fluid trap is in fluid communication with the patient.
The invention, together with the additional features and advantages thereof may best be understood by reference to the following description taken in connection with the accompanying illustrative drawings.